On a typical night, my brain races with anxiety, worried about everything from getting fired to being kicked out of therapy to whether or not my air conditioner will fall out of my window. For hours, I lie awake — until I feel two small, warm bodies cozy up next to me. My cats. As a sexual abuse survivor with PTSD, more often than not my mental health is somewhere between jumping out of my skin or unable to get off the couch. In these moments, it’s the comforting presence of my cats that helps anchor me to reality.

Mine is hardly a unique experience. Many cat owners who deal with mental illness have found cats to be of enormous help as well — and a surprising amount of empirical research backs up the particular role cats can play in providing mental-health therapy.

This is, of course, in part because animals in general are often of therapeutic use. “Cats, like any other animal, can help people from experiencing isolation or loneliness,” says Charlotte, North Carolina-based psychologist Lisa Long. “Animals can serve as a buffer to being alone. Animals boost serotonin and can significantly improve mood.”

A National Center for Biotechnology Information study found that spending time with an animal can increase the hormone oxytocin. Sometimes called the “cuddle chemical,” oxytocin increases pet owners’ sense of well-being. In addition, playing with a pet can increase serotonin and dopamine levels, two chemicals key in regulating mood disorders such as depression.

But while many animals have documented mental health benefits, it’s dogs that seem to get all the attention. A quick Google search for emotional support dogs yields nearly 5 million results, while emotional support cats get only 2.4 million hits, with a link to a dog-specific site on the first page of results. Animal-assisted therapy providers also tend to favor dogs; among many examples, Therapet in Tyler, Texas, has more than 90 dogs on their roster and only five cats. Therapy animal provider Paws Patrol in Albany, Georgia, features more than 25 dogs and two cats. The University of California, Los Angeles’ People-Animal Connection therapy program works exclusively with dogs.

The popularity of dogs in the role of therapy and emotional support may have something to do with the fact that cats are commonly viewed as anti-social, aloof, or independent. But not only is this partly rooted in widespread misconception (more on this later), the fact that cats are more independent and individual than dogs is actually the very reason they make for such valuable therapy animals.

“We actually find dogs kind of limiting. The fact that dogs are so accepting and non-judgemental is really good and helpful in the beginning of therapy,” says Linda Chassman, co-founder and executive director of Animal Assisted Therapy Programs of Colorado. “But it’s not very realistic when you’re trying to help a client who has social skills issues or who has anxiety, problems in the family, communication issues, [or] boundary issues. The dog just kind of puts up with bad behavior, whereas the cat won’t.”

Chassman practices animal-assisted psychotherapy, where animals serve as an integral part of a client’s mental health treatment plan. While Chassman works with a variety of animals in her practice, including dogs, horses, and goats, it was a cat who first turned her on to the idea of working with animals more than 20 years ago.

While working with severely traumatized children, Chassman’s cat Norman got involved in the process. Through learning what behaviors Norman wouldn’t tolerate — such as rough housing or yelling — the children began to understand how to interact in a healthy relationship. Like humans, cats won’t tolerate all behavior, making them useful mirrors to human interaction.

“They have enough interest in people, but can also assert themselves. And they have quiet dignity,” Chassman says. “They won’t let people walk on them. … I just think they’re wonderful role models for good relationships.”

According to Chassman, relationship role modeling can play out in couples and family therapy when clients observe how the cat reacts to what’s happening in the room:

“If you have a cat in the room, when there starts to be a fight or the tension starts to rise, it is going to get up and want to leave, or is going to at least pick its head up and signal that it’s getting uncomfortable. It’s really easy to watch the cat’s behavior and say, ‘That’s interesting, what did the cat just do?’… And then you can say, ‘Let’s see if we can have this same conversation and have the cat in the room. Let’s see if we can talk about this in a way that allows the cat to go back to sleep.’”

Cats aren’t just helpful for mirroring couple and family dynamics; they are also critical in helping people who struggle with mental illnesses such as post-traumatic stress disorder or anxiety learn about emotional regulation.

“The emotional regulation is something we deal with a lot because we get a lot of kids and adults who don’t have the ability to calm themselves down,” Chassman says. “Being able to rhythmically pet the cat and just kind of focus on stroking the cat’s back, or seeing how the cat responds, can be really helpful.”

Though most animals respond favorably to being pet, having clients strive to get a cat to purr can make all the difference. Unique to cats, not only does purring provide a tangible goal for emotional regulation, it has its own health benefits as well.

“[Scientists] discovered that the purring frequency of cats is a hertz rate that is equal to what they call the gamma waves, which are the meditation waves,” says Shawn Simons, headmistress of Kitty Bungalow: Charm School for Wayward Cats in Los Angeles. “So the purring of your cat actually helps to incite additional gamma rays for you. It helps to slow down your breathing. [It helps] with anxiety [and] high blood pressure. It has a meditative quality, which has extremely positive health ramifications.”

Other studies, too, have illuminated the benefits of having a cat by your side.

A study by the Cats Protection agency in the UK surveyed 600 participants, half of whom struggled with their mental health. They discovered that 87% of cat owners found their cats to have a positive effect on their well-being. In addition, 76% reported cats made regular stressors easier to manage.

Cornwell College student Filipa Denis studied the benefit of human attachment with cats, and found that humans who were attached to their cats experienced great calming effects from the relationship. Cats also fulfill the human need for touch, especially for those whose mental illness prevents them from easily forming attachments with other people. Contrary to popular belief, cats can be affectionate and attached to their humans as well.

“There’s kind of a misnomer that cats are not social creatures. They’ve proven through studying feral colonies that cats are actually very social and they choose to live in social groups,” says Charlottesville, Virginia-based cat behaviorist, Ami Somers. “Cats have a similar connection with people, especially when they’ve been socialized with people early on in life. They want to be with you and they want to connect with you. The truth is cats are very social and they’re very trainable and they do enjoy living with people.”

For forming attachments, providing companionship, and easing mental health symptoms, cats can be an ideal emotional support animal for at-home companionship as well.

“A few years ago, after I was shot, I went through hell, physically, emotionally, mentally, and socially,” says Becky Cole. “I was diagnosed with PTSD and depression. It was my cat, Simon, who got me through it all. There were nights where I wouldn’t realize I was crying in my sleep and I would wake up to him licking my tears. He was my bridge back into the human world, because he kept me from shutting down altogether. It was almost like he was forcing his paw in the door, so I couldn’t shut it completely on everything.”

Though only dogs and miniature horses qualify as service animals, cats can be considered emotional support animals, designated as “comfort animals” to those with mental illnesses. Accommodations for ESAs are not as extensive as service animals, but they do qualify for protections under the Fair Housing Act. For example, ESAs must be permitted in housing with a “no pet policy,” as landlords are required to provide “reasonable accommodation” for those who rely on an animal for support. To qualify for an ESA, a mental health professional must supply an official letter.

“Similar to a person who needs glasses in order to be able to see, the animal serves a function to improve the psychological functioning of the person,” Long says. “In order to have [an emotional support] animal, a mental health provider would have to deem it as a necessary accommodation to help the individual through everyday life.”

Cats may be often overlooked, but whether serving as a critical companion at home, an official emotional support animal, or a part of the healing process in therapy, they can greatly improve our mental health.

“I have dealt with depression, anxiety, and panic attacks for over 20 years,” says Alyssa Heller. “My mental health has improved tremendously since [my cat] Shadow came into my life. … I am definitely happier, I don’t cry nearly as often, and the anxiety is much more manageable. … On the days I’m having a rough mental health episode, her presence enables me to work through the symptoms and I rarely have to call on family or friends for assistance anymore. I highly recommend a cat as a companion animal to anyone who deals with mental health issues.”

My cats have become integral to my own mental health — and I wouldn’t have it any other way. They make sure I get out of bed in the morning and keep me moving forward. Their playful antics bring me joy and their warm presence at night helps me fall asleep.

Most importantly, their constant companionship reminds me that I have value and purpose.